Preirradiation sinus mucosal disease in patients with nasopharyngeal carcinoma

Purpose: The objective of this study was to evaluate the incidence and the possible risk factors for preirradiation abnormalities of the sinus mucosa in patients with nasopharyngeal carcinoma (NPC) by magnetic resonance imaging. Materials and methods: Medical records and magnetic resonance imaging results were reviewed and compared between a group of patients with NPC and a control group. The Lund-Mackay system for staging of rhinosinusitis (Lund score) was used as a tool for the investigation. Results: The incidence of sinus mucosal abnormalities was 32.1% in the NPC group and 20.7% in the control group (P = .041). The patients with NPC demonstrated a higher incidence of sinus abnormalities in nearly all sinuses. However, only the incidence of disease in the posterior ethmoid (P = .002) and sphenoid sinus (P = .006) was significantly increased in patients with NPC. The incidence and the severity of sinus abnormalities in male patients with NPC were significantly higher than that in female patients. Patients with advanced T stage showed significantly higher Lund scores (P = .015) than patients with early T stage. Conclusion: The results supported the hypothesis that patients with NPC might be prone to have chronic infection and might be partially immunocompromised by Epstein-Barr virus. Female patients may have an inherited genetic advantage that protects against Epstein-Barr virus infection or lessens its devastating effects.